Individual provider Active NPI

Moishe Dawn Shayland-Williams, MSW, LCSW

  • Clinical Social Worker
  • Paterson, NJ
National Provider Identifier
1457617052
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05287300 Issued in NJ
Practice address
475 Park Ave
Paterson, NJ 07504-1851
Phone
(973) 600-3021
NPI assigned
Apr 9, 2012
Last updated
Apr 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05287300 NJ Primary
School Social Worker 1041S0200X 00293374 NJ

Addresses

Primary practice location

475 Park Ave
Paterson, NJ 07504-1851

Mailing address

87-89 Mill Street
Paterson, NJ 07501
Phone (973) 600-3021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
44SC05287300NJMDClinical Social Worker
00293374NJMDSchool Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Copeland Counseling Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1457617052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87-89 MILL STREET",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07501",
            "telephone_number": "973-600-3021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 PARK AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075041851",
            "telephone_number": "973-600-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYLAND-WILLIAMS",
        "first_name": "MOISHE",
        "middle_name": "DAWN",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05287300",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NJ",
            "license": "00293374",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.